I work at Western State Hospital with incredibly dedicated doctors, nurses, psychologists, social workers, therapists, counselors, custodians, pharmacists, mental health technicians, groundskeepers, ward clerks, librarians, security officers, maintenance workers, carpenters, office assistants, kitchen staff and many, many more.
We are often the closest thing to a family that our patients have. We have been here, for them, 24 hours every day, seven days every week, year after year, for the past 144 years.
It breaks our hearts not to be able to provide the care they need. Those of us who work every day with patients feel a sense of futility as we're asked to put more effort into paperwork fixes which simply give the illusion of care. Yet, our desperate requests for more time and more people to work with patients have been marginalized as naive and simply ignored.
Our patients have suffered as a result. Some have died. Our staff have been seriously injured. We've endured, as much as possible, the overriding imperative handed from the top down, to cut costs. Superficial fixes and the maintenance of an illusion of care have become priorities.
With each citation from The Joint Commission (which provides accreditation) or the federal Centers for Medicare and Medicaid Services, another layer of these paper fixes are mandated by an administration focused on spending the least amount of money while just barely maintaining federal accreditation. An increasingly greater percentage of limited resources go toward building this facade of care directed at CMS and the Joint Commission without investing the necessary resources to truly improve care.
A good hospital is run by “caring.” An uncompromising priority to genuinely care for the health and safety of each individual patient and staff requires a hospital’s leaders to demonstrate courage. It requires a willingness to forgo politics and address the stark reality for what it is.
This degree of courage has not been apparent over the past few of years at Western State Hospital.
Recently surveyors from CMS cited the hospital for several very serious problems. The medical staff had repeatedly warned the hospital administration and the Department of Social and Health Services of these very same problems for more than a year. We repeatedly told the CEO of Western State Hospital and the assistant secretaries and secretary of DSHS about our concerns regarding hospital safety, patient care and staffing levels. We were told that these concerns were beyond our jurisdiction and/or lacked significance.
As the CMS announced its conclusions, the hospital administration and DSHS suddenly made an about-face. For many of us, this made it clear that our personal view as care providers meant very little to the hospital administration and DSHS. It was simply the potential loss of $64 million from the CMS that, to the hospital administration and DSHS, meant everything.
The hospital’s official policy stipulates that employees who have contact with the media must state that their views do not reflect the official views of the hospital or DSHS. In this instance, the views here reflect my personal opinions as a physician and likely the majority of us who have provided the day-to-day care for our patients for decades. Sadly, they do not reflect the views of those who are officially in charge of the hospital.
Dr. Joseph Wainer is a psychiatrist at Western State Hospital.